Testes autonômicos e efeito agudo do exercício isométrico sobre a frequência cardíaca e a modulação parassimpática de pessoas com diabetes do tipo 2
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Data
2019-01-10
Autores
Cogo, Pauline Romualdo
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Universidade Estadual Paulista (Unesp)
Resumo
Introdução: A Diabetes Mellitus do tipo 2 (DM2) pode levar à disfunções no sistema nervoso autônomo (SNA), que contribuem para o aparecimento de comorbidades no sistema cardiocirculatório. A variabilidade da frequência cardíaca (VFC) e os testes sugeridos por Ewing et al., (1985) são ferramentas muito utilizadas nos dias atuais para a avaliação da integridade desse sistema. Além disso, tem sido verificado que indivíduos com DM2 apresentam déficits nas respostas da frequência cardíaca (FC) durante exercício físico, associados às disfunções do SNA. Objetivo: Investigar o desempenho de diabéticos nos testes de função autonômica, a modulação autonômica de repouso e os ajustes parassimpáticos e da FC que ocorrem durante o exercício isométrico de preensão palmar. Metodologia: A amostra foi composta por indivíduos de ambos os sexos, acima de 40 anos, divididos em dois grupos: com e sem DM2. Foram aplicados quatro testes provocativos propostos por Ewing et al., 1985, sendo um modificado. A coleta da VFC de repouso foi realizada por 20 minutos consecutivos, em decúbito dorsal, foram selecionados 256 pontos para o cálculo dos índices temporais, espectrais e simbólicos. Os indivíduos realizaram contração isométrica voluntária durante um minuto com intensidades de 10, 20, 30, 40 e 50% da carga máxima, sendo utilizados os índices parassimpáticos RMSSD, SD1 e a FC para análise. Resultados: As respostas dos testes autonômicos, os índices lineares e simbólicos da VFC de repouso e os obtidos durante o exercício foram similares (p-valor > 0,05), também não foi encontrada associação da VFC de repouso com os testes aplicados a os ajustes parassimpáticos do exercício. Conclusão: Não foram evidenciadas diferenças entre os grupos na modulação de repouso, nas respostas aos testes autonômicos e nos ajuste parassimpáticos e da FC no exercício, bem como, qualquer associação significativa entre as variáveis estudadas.
Introduction: Diabetes mellitus type 2 (DM2) can lead to dysfunction in the autonomic nervous system (ANS), which contributes to the appearance of comorbidities in the cardiocirculatory system. The heart rate variability (HRV) and the tests suggested by Ewing et al. (1985) are currently widely used tools for assessing the integrity of this system. In addition, it has been verified that individuals with DM2 present deficits in heart rate (HR) responses during exercise, associated with ANS dysfunctions. Objective: To investigate the performance of diabetics in the autonomic function tests, the autonomic modulation at rest and the parasympathetic and HR adjustments that occur during isometric handgrip exercise. Methodology: The sample consisted of individuals of both sexes, over 40 years old, divided into two groups: with and without DM2. Four provocative tests proposed by Ewing et al., 1985 were applied, being one modified. The collection of resting HRV was performed for 20 consecutive minutes in dorsal decubitus, 256 points were selected for the calculation of temporal, spectral and symbolic indexes. The subjects underwent voluntary isometric contraction for one minute with intensities of 10, 20, 30, 40 and 50% of maximum load, using the parasympathetic indexes RMSSD, SD1 and HR for analysis. Results: The responses of the autonomic tests, the linear and symbolic indexes of the HRV at rest and those obtained during exercise were similar (p-value > 0.05); neither was HRV at rest associated with the tests applied to the parasympathetic adjustments of the exercise. Conclusion: There were no differences between the groups in resting modulation, in the responses to the autonomic tests and in the parasympathetic and HR adjustments in the exercise, as well as any significant association between the studied variables.
Introduction: Diabetes mellitus type 2 (DM2) can lead to dysfunction in the autonomic nervous system (ANS), which contributes to the appearance of comorbidities in the cardiocirculatory system. The heart rate variability (HRV) and the tests suggested by Ewing et al. (1985) are currently widely used tools for assessing the integrity of this system. In addition, it has been verified that individuals with DM2 present deficits in heart rate (HR) responses during exercise, associated with ANS dysfunctions. Objective: To investigate the performance of diabetics in the autonomic function tests, the autonomic modulation at rest and the parasympathetic and HR adjustments that occur during isometric handgrip exercise. Methodology: The sample consisted of individuals of both sexes, over 40 years old, divided into two groups: with and without DM2. Four provocative tests proposed by Ewing et al., 1985 were applied, being one modified. The collection of resting HRV was performed for 20 consecutive minutes in dorsal decubitus, 256 points were selected for the calculation of temporal, spectral and symbolic indexes. The subjects underwent voluntary isometric contraction for one minute with intensities of 10, 20, 30, 40 and 50% of maximum load, using the parasympathetic indexes RMSSD, SD1 and HR for analysis. Results: The responses of the autonomic tests, the linear and symbolic indexes of the HRV at rest and those obtained during exercise were similar (p-value > 0.05); neither was HRV at rest associated with the tests applied to the parasympathetic adjustments of the exercise. Conclusion: There were no differences between the groups in resting modulation, in the responses to the autonomic tests and in the parasympathetic and HR adjustments in the exercise, as well as any significant association between the studied variables.
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Palavras-chave
Diabetes Mellitus, Sistema nervoso autônomo, Frequência cardíaca, Exercício, Sistema nervoso parassimpático, Autonomic nervous system, Heart rate, Exercise, Parasympathetic nervous system